Spontaneous Pregnancy After Isotretinoin Use in a Man After Unsuccessful Microdissection Testicular Sperm Extraction

We report a spontaneous pregnancy in the partner of a man with non-obstructive azoospermia and histologically confirmed late maturation arrest following a failed microdissection testicular sperm extraction (micro-TESE). This patient was subsequently treated with isotretinoin for six months and, thereafter, conceived naturally without any assisted reproductive techniques. This case suggests the possibility of improvement in sperm production in men with nonobstructive azoospermia (NOA) despite lack of success with surgical sperm retrieval and implicates isotretinoin as a potential therapeutic agent that is noninvasive and cost-effective. While causality cannot be established from a single case, these findings warrant further investigation in prospective studies.